Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
J Surg Oncol. 2014 Jun;109(8):760-3. doi: 10.1002/jso.23588. Epub 2014 Mar 7.
We investigated the prognostic value of qualitative lymphoscintigraphy in gynecological cancer-related lymphedema, which is a common complication after treatment.
All 152 patients underwent (99m) Tc tin-colloid lymphoscintigraphy before complex decongestive therapy (CDT). We analyzed the uptake patterns of the inguinal lymph nodes, main lymphatic vessel and collateral lymphatic vessels, as well as dermal back flow. We compared these lymphoscintigraphic findings and other clinical variables between good and poor therapeutic responders using Pearson's Chi-squared test, Fisher's exact test and multiple logistic regression analysis.
Eighty-nine patients (58.6%) had a poor therapeutic response to CDT. In univariate analysis, there were significant differences between good and poor responders in clinical stage (P < 0.001), therapy compliance (P < 0.001), main lymphatic vessel uptake pattern (P < 0.01), collateral lymphatic vessel uptake pattern (P < 0.01) and severity of dermal back flow (P < 0.001). After multivariate analysis, only severity of dermal back flow (P < 0.005), clinical stage (P < 0.05) and therapy compliance (P < 0.001) were found to be independent predictors of therapeutic response.
Lymphoscintigraphy may be useful to predict the outcome of patients with gynecological cancer-related lymphedema undergoing CDT along with clinical stage and compliance.
我们研究了定性淋巴闪烁显像在妇科癌症相关淋巴水肿中的预后价值，该疾病是治疗后的常见并发症。
所有 152 例患者在复杂消肿治疗（CDT）前均行 99mTc 锡胶体淋巴闪烁显像。我们分析了腹股沟淋巴结、主要淋巴管和侧支淋巴管的摄取模式以及真皮逆流。我们通过 Pearson 卡方检验、Fisher 确切检验和多因素逻辑回归分析比较了这些淋巴闪烁显像结果与其他临床变量在治疗反应良好和不良的患者之间的差异。
89 例（58.6%）患者对 CDT 的治疗反应不佳。在单因素分析中，治疗反应良好和不良的患者在临床分期（P<0.001）、治疗依从性（P<0.001）、主要淋巴管摄取模式（P<0.01）、侧支淋巴管摄取模式（P<0.01）和真皮逆流严重程度（P<0.001）方面存在显著差异。多因素分析后，仅真皮逆流严重程度（P<0.005）、临床分期（P<0.05）和治疗依从性（P<0.001）是治疗反应的独立预测因素。
淋巴闪烁显像结合临床分期和依从性可能有助于预测妇科癌症相关淋巴水肿患者接受 CDT 的治疗效果。
